Prospective Clinical and Molecular Evaluation of Potential Plasmodium ovale curtisi and wallikeri Relapses in a High-transmission Setting

Groger, Mirjam; Veletzky, Luzia; Lalremruata, Albert; Cattaneo, Chiara; Mischlinger, Johannes; Zoleko, Rella Manego; Kim, Johanna; Klicpera, Anna; Meyer, Elias Laurin; Blessborn, Daniel; Winterberg, Markus; Adegnika, Ayôla Akim; Agnandji, Selidji Todagbé; Kremsner, Peter G.; Mordmüller, Benjamin; Mombo-Ngoma, Ghyslain; Fuehrer, Hans‐Peter; Ramharter, Michael

doi:10.1093/cid/ciz131

Cited by 42 publications

(47 citation statements)

References 36 publications

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“…ovale curtisi reappearing in shorter time intervals compared to P. ovale wallikeri [21]. Asymptomatic infections with P. malariae were also common with 8% in the present study.…”

Section: Resultssupporting

confidence: 47%

High prevalence of asymptomatic malaria infections in adults, Ashanti Region, Ghana, 2018

Heinemann

Phillips

Vinnemeier

et al. 2020

Preprint

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Background Ghana is among the high-burden countries for malaria infection and recently reported a notably increase in malaria cases. While asymptomatic parasitemia is increasingly recognized as a hurdle for malaria elimination, studies on asymptomatic malaria are scarce and usually focus on children and on non-falciparum species. The present study aims to assess the prevalence of asymptomatic Plasmodium falciparum and non-falciparum infections in Ghanaian adults in the Ashanti region during the high transmission season. Methods Asymptomatic adult residents from five villages in the Ashanti Region, Ghana, were screened for Plasmodium spp. by rapid diagnostic test (RDT) and polymerase chain reaction (PCR) during the rainy season. Samples tested positive were subtyped using species-specific real-time PCR. For all P. ovale infections additional sub-species identification was performed.Results Molecular prevalence of asymptomatic Plasmodium infection was 284/391 (73%); only 126 (32%) infections were detected by RDT. While 266 (68%) participants were infected with Plasmodium falciparum, 33 (8%) were infected with Plasmodium malariae and 34 (9%) with Plasmodium ovale. The sub-species Plasmodium ovale curtisi and P. ovale wallikeri were identified to similar proportions. Non-falciparum infections usually presented as mixed infections with Plasmodium falciparum.Conclusions Most adult residents in the Ghanaian forest zone are asymptomatic Plasmodium carriers. The high Plasmodium prevalence not detected by RDT in adults highlights that malaria eradication efforts must target all members of the population. Beneath Plasmodium falciparum, screening and treatment must also include infections with Plasmodium malariae, P. ovale curtisi and P. ovale wallikeri .

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“…ovale curtisi reappearing in shorter time intervals compared to P. ovale wallikeri [21]. Asymptomatic infections with P. malariae were also common with 8% in the present study.…”

Section: Resultssupporting

confidence: 47%

High prevalence of asymptomatic malaria infections in adults, Ashanti Region, Ghana, 2018

Heinemann

Phillips

Vinnemeier

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…However, a recent study provides direct evidence, using molecular methods, of the reappearance of P. ovale curtisi strains, in line with currently accepted relapse theory. Interestingly, the relapse of P. ovale wallikeri was not observed in this study [19]. In our study, there were 6 mixed cases of P. ovale spp.…”

Section: Discussioncontrasting

confidence: 59%

Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019

Zhang

Wang

Wang³

et al. 2020

Preprint

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Background Although autochthonous malaria cases are no longer reported in Anhui Province, China, imported malaria has become a major health concern. The proportion of reported malaria cases caused by Plasmodium ovale spp. increased to levels higher than expected during 2012 to 2019, and showed two peaks, 19.69% in 2015 and 19.35% in 2018. Methods We conducted a case-based retrospective study, using data collected from the China Information System for Disease Control and Prevention and Information System for Parasitic Disease Control and Prevention from 2012–2019, to describe the trends and differences between P. o. curtisi and P. o. wallikeri. Epidemiological characteristics were analyzed using descriptive statistics. Results P. ovale curtisi and P. ovale wallikeri were found simultaneously circulating in 14 African countries. Among 128 patients infected with P. ovale spp., the proportion of mixed infection cases was 10.16%. Six cases of co-infection by P. ovale and P. falciparum were observed, each presenting with two clinical attacks (the first attack was due to P. falciparum and the second was due to P. ovale spp.) at different intervals. Accurate identification of the infecting species was achieved in only 20.00% of cases with P. ovale infection. At the reporting units, 32.17% and 6.96% of P. ovale spp. cases were misdiagnosed as P. vivax and P. falciparum, respectively. Conclusion Our finding indicates that the ability of P. ovale spp. to co-infect with other malarial species has been previously underestimated and providing rational evidence for the existence of hypnozoites in P. ovale spp. P. o. curtisi and P. o. wallikeri circulate simultaneously in Africa, and the incidence of P. ovale spp. is probably also underestimated in these source countries where the disease is endemic. Given the low rate of species identification, more sensitive point-of-care detection methods need to be developed for P. ovale spp., and introduced in non-endemic areas.

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“…However, a recent study provides direct evidence, using molecular analyses, of the reemergence of P. ovale curtisi strains, concurrent with the currently accepted relapse theory. Interestingly, relapse of P. ovale wallikeri infections was not noted in this study [19]. In this study, mixed infections of P. ovale spp.…”

Section: Discussioncontrasting

confidence: 48%

Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019

Zhang

Wang

Wang³

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundAlthough autochthonous malaria cases are no longer reported in Anhui Province, China, imported malaria has become a major health concern. The proportion of reported malaria cases caused by Plasmodium ovale spp. increased to levels higher than expected during 2012 to 2019, and showed two peaks, 19.69 % in 2015 and 19.35 % in 2018.MethodsA case-based retrospective study was performed using data collected from the China Information System for Disease Control and Prevention (CISDCP) and Information System for Parasitic Disease Control and Prevention (ISPDCP) from 2012 to 2019 to assess the trends and differences between Plasmodium ovale curtisi (P. o. curtisi) and Plasmodium ovale wallikeri (P. o. wallikeri). Epidemiological characteristics were analyzed using descriptive statistics.ResultsP. ovale curtisi and P. ovale wallikeri were found to simultaneously circulate in 14 African countries. Among 128 patients infected with P. ovale spp., the proportion of mixed infection cases was 10.16%. Six cases of co-infection with P. ovale spp. and P. falciparum were noted, each presenting with two clinical attacks (the first attack was due to P. falciparum and the second was due to P. ovale spp.) at different intervals. Accurate identification of the infecting species was achieved among only 20.00% of cases of P. ovale spp. infection. At the reporting units, 32.17% and 6.96% of cases of P. ovale spp. infection were misdiagnosed as P. vivax and P. falciparum infections, respectively.ConclusionThe present results indicate that the potential of P. ovale spp. to co-infect with other Plasmodium species has been previously underestimated, as is the incidence of P. ovale spp. in countries where malaria is endemic. P. o. curtisi may have a long latency period of >3 years and potentially cause residual foci, thus posing challenges to the elimination of malaria in P. ovale spp.-endemic areas. Considering the low rate of species identification, more sensitive point-of-care detection methods need to be developed for P. ovale spp. and introduced in non-endemic areas.

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Prospective Clinical and Molecular Evaluation of Potential Plasmodium ovale curtisi and wallikeri Relapses in a High-transmission Setting

Cited by 42 publications

References 36 publications

High prevalence of asymptomatic malaria infections in adults, Ashanti Region, Ghana, 2018

High prevalence of asymptomatic malaria infections in adults, Ashanti Region, Ghana, 2018

Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019

Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019

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Prospective Clinical and Molecular Evaluation of Potential Plasmodium ovale curtisi and wallikeri Relapses in a High-transmission Setting

Cited by 42 publications

References 36 publications

High prevalence of asymptomatic malaria infections in adults, Ashanti Region, Ghana, 2018

High prevalence of asymptomatic malaria infections in adults, Ashanti Region, Ghana, 2018

Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019

Epidemiological&nbsp;profile&nbsp;of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019

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Epidemiological profile of Plasmodium ovale spp. imported from Africa to Anhui Province, China, 2012 – 2019